Davidson M, Schraer C D, Parkinson A J, Campbell J F, Facklam R R, Wainwright R B, Lanier A P, Heyward W L
Arctic Investigations Laboratory, Centers for Disease Control, Anchorage, AK 99501.
JAMA. 1989 Feb 3;261(5):715-8.
From 1980 through 1986, one hundred fourteen Alaska Native patients from the Yukon-Kuskokwim Delta had community-acquired invasive pneumococcal disease confirmed by isolates of Streptococcus pneumoniae from normally sterile body sites. The annual bacteremia rates per 100,000 persons were 105 cases for all ages, 1195 cases for infants under 2 years of age, and 130 cases for adults over 59 years of age. These were six to 34 times higher than rates reported for other US populations. The most common underlying conditions in infants diagnosed before 24 months of age were previously diagnosed anemia and pneumonia, while alcoholism and anemia were most common in adults. The case-fatality rate for infants under 2 years of age was 3.2%, and the case-fatality rate for adults over 59 years of age was 30%. Serotyping of more than half the isolates identified 96% of these isolates to be present in the currently available pneumococcal polysaccharide vaccine. The pneumococcal disease rates reported herein are likely to be underestimates since most diseases that occur in this region are treated at the village level without laboratory confirmation.
从1980年到1986年，育空-库斯科基姆三角洲的114名阿拉斯加原住民患者被确诊患有社区获得性侵袭性肺炎球菌疾病，病原体为从通常无菌的身体部位分离出的肺炎链球菌。每10万人的年菌血症发病率在各年龄段中，所有年龄组为105例，2岁以下婴儿为1195例，59岁以上成年人则为130例。这些发病率比美国其他人群报告的发病率高出6至34倍。24个月前诊断出的婴儿最常见的基础疾病是先前诊断出的贫血和肺炎，而酗酒和贫血在成年人中最为常见。2岁以下婴儿的病死率为3.2%，59岁以上成年人的病死率为30%。超过一半分离株的血清分型表明，这些分离株中有96%存在于目前可用的肺炎球菌多糖疫苗中。本文报告的肺炎球菌疾病发病率可能被低估了，因为该地区发生的大多数疾病是在村级进行治疗，没有实验室确诊。
